Otitis Media Explanation – Types and symptoms

Otitis media is considered an infection or inflammation of the middle ear. It is the most common reason for children to visit the GP. Ear infections usually happen in ages of less than four years, but anyone can get an ear infection.

Usually, otitis media occurs due to bacterial or viral infection. However, in some […]

Otitis media is considered an infection or inflammation of the middle ear. It is the most common reason for children to visit the GP. Ear infections usually happen in ages of less than four years, but anyone can get an ear infection.

Usually, otitis media occurs due to bacterial or viral infection. However, in some cases, otits media can form with no apparent reason. There are 2 main types of otitis media: acute otitis media, and chronic otitis media. Sometimes the infections are also accompanied by effusion. Effusion means fluid in the middle ear space occasionally rupturing the ear drum.

The middle ear consists of the eardrum and an air filled space behind the eardrum and connected to the back of the throat by narrow passage called the Eustachian tubes. These channels are responsible for funneling fluids from the middle ear to the throat, as well as balancing the pressure in the middle ear to allow better hearing. When the air filled space in the middle ear becomes filled with fluid (mucus), the Eustachian tubes are blocked and dysfunction properly, causing fluid buildup inside the middle ear and elevated pressure on the eardrum.

Types of otitis media

Acute otitis media

Acute otitis media is characterized by the presence of fluid in the middle ear and is often preceded by a cold or other viral upper respiratory infection. The inflammation and fluid buildup cause obstruction of the Eustachian tube, generating a negative pressure, which pulls in fluid and may provide fertile growth conditions for bacteria. Children are usually more affected than adults, especially between the ages of 6 months to 3 years. Acute otitis media is accompanied by ear infection symptoms such as ear pain, puss, redness of the eardrum, and in some cases fever.

Chronic otitis media

A chronic ear infection that is accompanied by persistent fluid in the middle ear. Hearing impairment of varying severity is common in the affected ear. Risk factors that may boost Chronic Otitis Media include: Multiple episodes of acute otitis media, daycare with children who have infections, Craniofacial anomalies (such as cleft palate), passive smoking, crowded environment and upper respiratory infections.

Otitis media with effusion is an inflammation and fluid buildup (effusion) in the middle ear without apparent symptoms of infection, making it difficult to detect. Chronic otitis media with effusion can develop within weeks of an acute OME episode, yet in many cases the cause is unknown.

Chronic otitis media may occur when the Eustachian tube, connecting the middle ear to the throat, is no functioning or plugged. Fluid cannot drain and builds up behind the eardrum.

Otitis media with effusion

Otitis media with effusion is usually associated to dysfunction or persistent blocking of the Eustachian tubes, causing negative pressure in the middle ear and leakage of fluid from small capillaries and blood vessels in the middle ear. The term ‘glue ear’ is often used to describe otitis media with effusion due to presence of a sticky fluid behind the eardrum that resembles glue. otitis media with effusion is usually much difficult to diagnose than acute otitis media since there are no apparent symptoms (such as pain). Malfunction of the Eustachian tubes may arise due to viral infections, birth defects or secondhand smoking. Otitis media with effusion is more common than acute otitis media. The distinction between the two conditions is important: when otitis media with effusion is confused with acute otitis media, often antibiotics are prescribed unnecessarily.

Acute otitis media with effusion is caused by bacteria that grow and cause pus to form behind the eardrum. This infection is very painful, usually with a sudden offset. Acute otitis media without effusion is a common situation, and is considered a very early infection before the middle ear fluid has formed. The eardrum, when inspected with autoscope, can be found to be red and inflamed.

The various types of Otitis Media can cause temporary or permanent hearing loss if not treated. If and when your child shows signs of ear infection, a visit to the doctor as soon as possible is recommended.

Acute Otitis Media – Signs and Symptoms

When it comes on suddenly, you may notice:

Pulling or rubbing the ears or constant movement of the head

Fussiness and irritation

continuous Crying that does not stop when the child is comforted

sudden wakeups, accompanied by crying

Fever

Loss of appetite (or refusing to eat) – may also indicate throat pain.

In some cases, usually when the infection is harsh, the infection is accompanied by Vomiting & Diarrhea.

Chronic Otitis Media with Effusion – Signs and Symptoms

When able to talk, the child may indicate:

A feeling that the ear is plugged or full.

When swallowing there is a “pop” feeling

Dizziness and balance issues

Ringing in the ears (also called Tinnitus)

Hearing is harder – turning up the volume on the TV or radio or sit very close to it.

Antibiotics, Painkillers and medicine

Some children with ear infections will be treated with antibiotics. Make sure you give all the medicine prescribed, even if the child feels better. Your son/daughter needs to take the medicine in full to completely cure the ear infection. Often, ear infections will clear without antibiotics, and the ‘watchful waiting’ technique is recommended. Tylenol® or Motrin® may be given for the fever, pain, and irritability but with minor doses to avoid side effects.

How to Help Prevent Ear Infections

While children get ear infections, there are things parents can do to try to prevent them:

Breast feeding may help to decrease the number of ear infections.

Always hold your baby with his head up during feeding time. The formula can get into the sinuses and enter the middle ear – causing an infection.

When blowing your child’s nose, have him blow gently with mouth open to prevent mucus drainage to the middle ear.

In cold and rainy weather Dress your child properly.

Instead of Junk food and microwaved food, healthy food and lots of water is always better.

Immunizations are up to date.

Cigarette smoke has been known to encourage ear infections. Do not smoke next to your children.

Follow-Up

Make an appointment in 2 weeks to be checked again after all the medicine is given and the child feels better. In some cases, children need to have a hearing test as part of their follow-up. When having lots of ear infections, one might be referred to a specialist, an ENT (ears, nose, and throat) doctor, to discuss ear tube surgery. There are many Alternative treatments, but the use of these treatments should be used with considerable discretion.

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